Senate advances H.861 to raise pay for select audio-only telehealth visits, adds flood-abatement deadline extension

The Vermont Senate on the floor advanced H.861, a bill that would increase reimbursement for a limited set of audio-only telehealth services from 75% to 100% of standard visit rates and repeal a sunset on telehealth coverage enacted in Act 6 of 2021.

Senator from Chittenden Southeast, reporting for the Senate Finance Committee, said the committee offered a strike-all amendment and added a time-sensitive section to address flooding last July. "H.861 as passed by the House is about two things: making sure everyone in Vermont can easily access their doctor and making sure doctors get paid fairly for their standard services of care," the senator said. "This bill would increase the reimbursement percentage from 75% to a 100% of standard rates for a very small number of audio-only telehealth services." The sponsor added that patient choice and clinical appropriateness remain required.

The sponsor told colleagues the bill does not pay for ad-hoc phone calls and applies only to visits that meet the standard-of-care coding for a traditional office visit under American Medical Association current procedural terminology (CPT) codes. When asked who determines clinical appropriateness, the sponsor said it is defined by those CPT codes.

The Department of Financial Regulation (DFR) reviewed usage and cost data for telehealth and audio-only services since Act 6 passed in 2021, the sponsor said. DFR's findings, as recounted on the floor, showed audio-only services represented about 0.5% of services during the pandemic year referenced and telehealth about 11% in 2021; more recently the sponsor said usage has declined and that DFR estimated the fiscal impact of parity as "de minimis." The sponsor also said many providers reported they would be unlikely to offer audio-only visits if reimbursement remained at lower levels, a change that could reduce access for rural and less-mobile Vermonters.

Section 3, added by the Senate Finance Committee, alters a filing deadline related to tax abatements for properties damaged by last summer's flooding. The amendment changes the municipal application deadline for reimbursement related to tax payments on flood-affected properties from April 15, 2024, "which was two days ago," to Nov. 15, 2024, to give affected communities more time to reach and assist eligible property owners. The sponsor said city managers from Barre and Montpelier told the committee they had received only about 60–70 abatement applications in one community on an estimated 350 damaged properties and remained backlogged processing hearings.

The Appropriations Committee reporter on the floor described the fiscal effect as minimal and noted the lift of the sunset could have a small Medicaid impact. The Senate adopted the Finance Committee's report by voice vote and ordered a third reading of H.861.

No final passage vote occurred during the session; the ordering for third reading advances the bill toward a future floor vote. The Senate recessed briefly during debate on the germaneness of the added abatement-deadline language before returning to adopt the committee report.

The Senate scheduled no final action on the bill that day; the chamber stood adjourned until 1 p.m. on Thursday, April 18.